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Organization
PACIFIC SMILE DENTAL CLINIC
Active
Organization
PACIFIC SMILE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARITZA MONDRAGON (FRONT OFFICE)
(951) 924-6370
Entity
Organization
Contact information
Practice address
25025 RED MAPLE LN STE 105, MORENO VALLEY, CA 92551-1137
(951) 924-6370
(951) 924-6374
Mailing address
25025 RED MAPLE LN STE 105, MORENO VALLEY, CA 92551-1137
(951) 924-6370
(951) 924-6374
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47031
CA
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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